VP of Clinical Excellence and Quality

AcuteCare Health System LLC•Oceanport, NJ

32d

About The Position

Under the direction of the Chief Clinical Officer, the Vice President of Clinical Excellence and Quality provide national leadership for quality, clinical performance improvement, utilization management, participant safety and clinical outcomes across all BoldAge PACE centers nationally. This executive builds a culture of excellence, continuous learning, and participant-centered care while ensuring strong alignment with the PACE model. The VP provides clinical guidance, training and professional development with the on-site clinical teams (RNs, LPNs, MA’s) to ensure evidence-based practice and quality participant care in conjunction with the VP of Operations. The VP oversees the site-level quality leaders and partners closely with the Director of Compliance, Medical Directors, and Operations Leaders, to deliver consistent, high-quality care and outstanding participant experiences. This role in conjunction with the CCO will assist in partnering with Regional Medical Directors related to quality improvement (QI) I and serves as the national executive owner for all enterprise quality outcomes, participant safety programs, and clinical quality performance across BoldAge PACE.

Requirements

Doctorate in Nursing preferred, Master’s in Nursing, Healthcare Administration, Public Health, Gerontology, or related field required.
RN strongly preferred; clinical certifications (CPHQ, CPPS) desirable.
10+ years of progressive healthcare quality experience, with 5+ years in senior leadership.
Experience in PACE, managed care, long-term care, or complex geriatric populations preferred.
Deep knowledge of CMS regulations, quality methodologies, improvement science, and patient safety systems.
Deep knowledge of data driven analytics, data analysis and advanced data interpretation.
Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance.
Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact.
Pass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen.

Responsibilities

In conjunction with the CCO will develop and execute the national quality and to support organizational growth and participant-centered care.
Lead enterprise-wide QI initiatives that strengthen clinical outcomes, reduce adverse events, and improve service experience.
Drive alignment across all markets through standardized quality processes, tools, and expectations.
Manage policy & procedures for organization, managing, creating and rolling out new policies and procedures with implementation and execution across the national footprint.
Lead and manage the standard operating procedures () committee from a national perspective and provide guidance to all members of the organization.
Collaborate with the Director of Compliance and VP of Operations on survey readiness, corrective action plans, and regulatory risk identification.
Focus on clinical outcomes, participant safety, and improvement initiatives while Compliance oversees regulatory audits, investigations, and reporting.
Participate as the clinical leader in surveys with oversight and approval of submission documents related to clinical care and requests for additional information and plan of corrections as needed.
Designs and participates in chart audits, survey readiness and clinical emergency preparedness (mock codes, etc.) in conjunction with site level clinical leadership and compliance team.
Oversee dashboards, key performance indicators, scorecards, and national reporting for quality, safety, utilization and participant experience indicators.
Lead root cause analyses (RCA) and organization-wide improvement initiatives based on data-driven and team-informed insights.
Present outcomes and recommendations to executive leadership and the National Quality Committee.
Evaluate data to identify trends, create and implement change management, education and implementation based on data outcomes and monitors and tracks improvement.
Monitor and implement strategies for specialist utilization and high-cost outliners management.
Participate in and lead the central authorization process (in conjunction with CCO, CAO and other appropriate team members) for hospital and SNF use.
Lead system-wide safety efforts, including sentinel event reviews, mitigation strategies, and improvement plans.
Strengthen processes for incident management, risk identification, and prevention of harm.
Participate in Complex Care Committee and Ethics Committee meetings.
Implement evidence-based standards, clinical pathways, and quality education programs across all PACE centers.
Mentor and lead regional and site-level Quality leaders, promoting consistent and high-performing quality operations.
Provide effective education to employees as needed (clinical and non-clinical) and monitoring of adherence.
Oversee participant satisfaction, service quality initiatives, and grievance/appeal trending in partnership with site, national, and compliance leaders.
Develop strategies that enhance communication, responsiveness, and service excellence.
Contribute to readiness activities for new PACE centers, acquisitions, and geographic expansion, ensuring quality infrastructure and performance expectations are in place.